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❑ Keller Canyon ❑ Ox Mountain ❑ Newby Island 19'forward <br /> Sanitary Landfill Sanitary Landfill Sanitary Landfill Landfill <br /> .901 Bailey Road 12310 San Mateo Road 1601 Dixon Landing Road 9999 S.Austin Road <br /> Pittsburg,CA 94.565 Half Moon Bay,CA 94019 Milpitas,CA 95035 Manteca,CA 95336 <br /> Phone(925)458-9800 Phone(650)726-1819 Phone(408)945-2800 Phone(209)982-4298 <br /> Fax(925)458-9891 Fax(650)726-9183 Fax(408)262-2871 Fax(209)982-1009 <br /> NON-HAZARDOUS WASTE MANIFEST <br /> `EN AT WASTE ACCEPTANCE N0. <br /> x as ssii va7 vi uf�.utare. <br /> AILING ADDRESS <br /> egreet e B24A <br /> YJ 1-� <br /> CITY,S'T-A ZIP REQUIRED PERSONAL PROTECTIVE EQUIPMENT <br /> . stn rancisco, CA 94105 <br /> Q GLOVES O GOGGLES O RESPIRATOR Q HARD HAT <br /> PHONE <br /> ii (415) 973-3773 QTY-VEK UOTHER <br /> CONTACT PERSON <br /> Q it y SPECIAL HANDLING PROCEDURES: <br /> SIGNATURE OF AUTHORIZED AGW/TITLE DATE ��//� <br /> 10 <br /> ��.. <br /> ' GENERATOR'S CERTIFICATION:I hereby certify that the above named material is no a haza s <br /> waste is defined by 40 CFR Part 261 or title 22 of the California code of regulations,has been property <br /> ;,:described,classified and packaged,and is in proper condition for transportation a-cording to applicable <br /> c' £;tegutatioris;AND,If the waste Is a treatment residue of a previously restricted hazardous waste <br /> ;3ubjeG to the Land Disposal Restrictions,I certify and warrant that the waste has been treated in RECEIVING FACILITY <br /> accordance With the requirements of 40 CFR Part 268 and is no longer a hazardous waste as defined by <br /> :40 CFR Part 261. <br /> WASTE.TYPE: <br /> ISPOSAL U SLUDGE <br /> U CONSTRUCTION U WOOD <br /> U DEBRIS U OTHER <br /> U SPECIAL WASTE <br /> GENERATING FACILITY <br /> _ <br /> ' i.a rop 1�liE a ori Litt woo <br /> TFiA.;; t?O T NOTES: VEHICLE LICENSE NUMBER T110 'NCJI 113ER' <br /> t <br /> ADDFINk <br /> CITY,STATE,ZIP <br /> Windsor, CA 95492 <br /> PHONE END 9UMP BOTTOM DUMP TRANSFER <br /> QxQ_1 A07 ❑ Ll, <br /> Y SIGNATURE OF AUTHORIZED AGENT OR DRIVER DATE ROLL-OFF(S) FLAT-BED VAN DRUMS <br /> ❑ ❑ ❑ ❑ <br /> fil <br /> CUBIC YARDS <br /> hereby certify that the above named material has been <br /> accepted and to the best of my knowledge the foregoing DISPOSAL METHOD: (TO BE COMPLETED BY LANDFILL) <br /> is true and accurate. <br /> DISPOSE OTHER <br /> O <br /> REMARKS SOIL <br /> U CONSTRUCTION <br /> FACILITY TICKET NUMBER DEBRIS <br /> U NON-FRIABLE <br /> ASBESTOS <br /> SIGNATURE OF AUTHORIZED AGENT DATE <br /> ? U WOOD <br /> U ASH <br /> U SPECIAL OTHER <br /> SCHEDULING MUST BE MADE PRIORTO 3:00 P.M.THE DAY PRIORTO EXPECTED ARRIVAL a ANY UNSCHEDULED LOADS ARE SUBJECT <br /> TO REFUSAL UPON ARRIVAL. ONGOING DAILY DELIVERIES MUST BE SCHEDULED WITH THE LANDFILL THE DAY BEFORE. <br /> !_C^ICOATr)0!` ]DO MAKIIFFCT it n A A ^ 0% A <br />